KELLY MARIE DE GROOT NPI 1538753983

NPI Information

NPI: 1538753983
Provider Name: KELLY MARIE DE GROOT
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
1601 GREENE ST
COLUMBIA, SC
ZIP 29208
Phone: (803) 777-7412
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Kelly Marie De Groot is a family nurse practitioner in Columbia, SC. Kelly Marie De Groot NPI is 1538753983. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1601 GREENE ST
COLUMBIA, SC
ZIP 29208-001
Phone: (803) 777-7412

The enumeration date for this NPI number is 2/25/2021 and was last updated on 12/12/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	5015315	NORTH CAROLINA	Yes
2	390200000X	Student in an Organized Health Care Education/Training Program				No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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